Urinary KIM-1, NGAL and L-FABP for the diagnosis of AKI in patients with acute coronary syndrome or heart failure undergoing coronary angiography
2015
Acute kidney injury (AKI) is a common complication after coronary
angiography. Early biomarkers of this disease are needed since increase in serum creatinine levels is a late marker. To assess the usefulness of urinary kidney injury molecule-1 (uKIM-1),
neutrophil gelatinase-associated lipocalin(uNGAL) and liver-type
fatty acid-binding protein(uL-FABP) for early detection of AKI in these patients, comparing their performance with another group of
cardiac surgerypatients. Biomarkers were measured in 193 patients, 12 h after intervention. In the ROC analysis, AUC for KIM-1, NGAL and L-FABP was 0.713, 0.958 and 0.642, respectively, in the coronary
angiographygroup, and 0.716, 0.916 and 0.743 in the
cardiac surgerygroup. Urinary KIM-1 12 h after intervention is predictive of AKI in adult patients undergoing coronary
angiography, but NGAL shows higher sensitivity and specificity. L-FABP provides inferior discrimination for AKI than KIM-1 or NGAL in contrast to its performance after
cardiac surgery. This is the first study showing the predictive capacity of KIM-1 for AKI after coronary
angiography. Further studies are still needed to answer relevant questions about the clinical utility of biomarkers for AKI in different clinical settings.
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